National Provider Identifier [NPI]: |
1205937570 |
Last Name Of The Provider |
CLOY |
First Name Of The Provider |
JAMES |
Middle Initial Of The Provider |
A |
Credentials Of The Provider |
M.D. |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
878 LAKELAND DR |
Street Address 2 Of The Provider |
|
City Of The Provider |
JACKSON |
Zip Code Of The Provider |
392164644 |
State Code Of The Provider |
MS |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
52 |
Number Of Services |
1146 |
Number Of Medicare Beneficiaries |
473 |
Total Submitted Charge Amount |
148285 |
Total Medicare Allowed Amount |
76279.61 |
Total Medicare Payment Amount |
53630.09 |
Total Medicare Standardized Payment Amount |
57851.01 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
118 |
Number Of Medicare Beneficiaries With Drug Services |
69 |
Total Drug Submitted ChargeAmount |
3008 |
Total Drug Medicare AllowedAmount |
1216.62 |
Total Drug Medicare PaymentAmount |
1156.88 |
Total Drug Medicare Standardized Payment Amount |
1156.88 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
41 |
Number Of Medical Services |
1028 |
Number Of Medicare Beneficiaries With Medical Services |
473 |
Total Medical Submitted Charge Amount |
145277 |
Total Medical Medicare Allowed Amount |
75062.99 |
Total Medical Medicare Payment Amount |
52473.21 |
Total Medical Medicare Standardized Payment Amount |
56694.13 |
Average Age Of Beneficiaries |
65 |
Number Of Beneficiaries Age Less65 |
203 |
Number Of Beneficiaries Age 65 to 74 |
147 |
Number Of Beneficiaries Age 75 to 84 |
84 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
299 |
Number Of Male Beneficiaries |
174 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
311 |
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
191 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
282 |
Percent Of With Atrial Fibrillation |
8 |
Percent Of With Alzheimers Disease or Dementia |
15 |
Percent Of With Asthma |
11 |
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
24 |
Percent Of With Chronic Kidney Disease |
30 |
Percent Of With Chronic Obstructive Pulmonary Disease |
16 |
Percent Of With Depression |
30 |
Percent Of With Diabetes |
46 |
Percent Of With Hyperlipidemia |
36 |
Percent Of With Hypertension |
75 |
Percent Of With Ischemic Heart Disease |
29 |
Percent Of With Osteoporosis |
4 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
33 |
Percent Of With Schizophrenia Other PsychoticDisorders |
11 |
Percent Of With Stroke |
10 |
Average HCC Risk Score Of Beneficiaries |
1.485 |